Retreat Registration Form

Yoga retreat registration form

Retreat dates:*

Name*

First

Last

Address*

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Emergency contact: *

Medical history: *

Past experience in yoga and meditation:

Accommodation Options:*

Apartment (couple 2 person package)

Apartment (single 1 person)

Private single room (1 person)

Shared twin room (1 person)

Term and conditions: *

I read, agree to, and accept all terms and conditions specified in the ‘Payment and Cancellation Policy’ section listed on this website.

Medical release consent*

I understand all the medical risks involved in this program and take full responsibility for any unexpected consequences.

Deposit: *

Kč 4,800 (approx €200)

You will be redirected to PayPal to make your deposit payment. As soon as we receive the payment we'll send you confirmation within 24h.